Parental Depression and Children’s Maladjustment: An Updated Meta-Analysis

• In Event: Perinatal Maternal Depression: Links to Early Childhood Psychological Adjustment and the Role of Father Involvement

Abstract

As many as 15 million children live with a parent with major depressive disorder (MDD; National Research Council, 2009). Research has demonstrated that less warmth and engagement from depressed parents (Lovejoy et al., 2000) is associated with increased risk of childhood (Gershoff, 2002) and adult maladjustment (Reitman & Asseff, 2010; Taillieu & Brownridge, 2013). Researchers disagree, however, on just how impactful having a depressed parent may be. Some studies show a strong effect on problem behaviors (Frye & Garber, 2005), whereas others suggest a small, or even null, effect (Fisher et al., 2015; Hoffman et al., 2006). This variability in magnitude suggests significant heterogeneity between studies and indicates a need to consolidate the literature. Several meta-analyses have considered the impact of parental psychopathology on children’s outcomes, but most have focused on either broad parental psychopathology (e.g., Connell & Goodman, 2002), and/or limited included studies to father- or mother-only samples (e.g., Goodman et al., 2011; Wilson & Durbin, 2010).

The present study addresses these limitations by meta-analyzing data on associations between parental depression and children’s internalizing and externalizing behaviors. We examined effect sizes from 37 studies conducted between 2000-2020, resulting in 128 effect sizes (81 internalizing, 47 externalizing). Using random effects models, we derived overall effect sizes across 10,149 participants. Parental depression had small to moderate effects on both internalizing (r=.21) and externalizing (r=.19) problems. Moderate heterogeneity between studies existed (I2int=56% and I2ext=54%), some of which was due to the inclusion of fathers in studies. For internalizing, studies with both mothers and fathers showed a stronger effect of parental depression (r=.26) than did father-only (r=.16) or mother-only (r=.20) studies. Conversely, studies with both mothers and fathers showed a weaker impact of parental depression on externalizing problems when compared to either mother-only (r=.22) or father-only (r=.14) studies. Further, the type of outcome measure is associated with differences in effect size: for example, broad subscales such as the Child Behavior Checklist showed larger effect sizes (r =.27) than more narrow inventories such as the Children’s Depression Inventory (r=.15).

The current meta-analysis showed that differences in reported effect sizes exist in recent literature on parental depression and children’s problem behavior, and that a portion of these differences are due to the inclusion or exclusion of fathers. Studies including both mothers and fathers reported stronger effects of depression on internalizing problems but weaker effects on externalizing problems. Our findings suggest that across studies, parental depression has a reliable effect on both child internalizing and externalizing symptoms. Furthermore, the inclusion of both mothers and fathers in samples is associated with variability in effect sizes, perhaps due to increased rigor of the associated studies. The lack of eligible studies examining fathers’ clinical depression supports a call to researchers to prioritize collecting data from this population of parents, as only 16% of retained studies included fathers in the sample. Finally, this meta-analysis highlights the importance of using narrow-concept inventories when exploring child problem behaviors, as reports of broad spectrums of behaviors may artificially inflate the effect size.

Authors

• Lauren Aaron, University of New Orleans
  Presenting Author

• Rachel M Kaplan, University of New Orleans

• Sarah Black, University of New Orleans